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Clinical Usefulness of 18F-Fluorodeoxyglucose-Positron Emission Tomography in Patients With Locally Advanced Pancreatic Cancer Planned to Undergo Concurrent Chemoradiation Therapy

Authors
 Jee Suk Chang  ;  Seo Hee Choi  ;  Youngin Lee  ;  Kyung Hwan Kim  ;  Jeong Youp Park  ;  Si Young Song  ;  Arthur Cho  ;  Mijin Yun  ;  Jong Doo Lee  ;  Jinsil Seong 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.90(1) : 126-133, 2014 
Journal Title
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 
ISSN
 0360-3016 
Issue Date
2014
MeSH
Aged ; Chemoradiotherapy*/mortality ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18*/pharmacokinetics ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis/diagnostic imaging ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/mortality ; Pancreatic Neoplasms/diagnostic imaging* ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Positron-Emission Tomography/methods* ; Radiopharmaceuticals/pharmacokinetics*
Abstract
Purpose : To assess the role of coregistered 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting radiographically occult distant metastasis (DM) at staging in patients with locally advanced pancreatic cancer (LAPC) and to study whether FDG-PET parameters can predict relatively long-term survival in patients who are more likely to benefit from chemoradiation therapy (CRT). Methods and Materials : From our institutional database, we identified 388 LAPC patients with M0 on conventional computed tomography (CT) who were planned to undergo CRT. Coregistered FDG-PET staging was offered to all patients, and follow-up FDG-PET was used at the clinical discretion of the physician. Results : FDG-PET detected unsuspected CT-occult DM in 33% of all 388 patients and allowed them to receive systemic therapy immediately. The remaining 260 patients (PET-M0) underwent CRT selectively as an initial treatment. Early DM arose in 13.1% of 260 patients, and the 1-year estimated locoregional recurrence rate was 5.4%. Median overall survival (OS) and progression-free survival (PFS) were 14.6 and 9.3 months, respectively, at a median follow-up time of 32.3 months (range, 10-99.1 months). Patients with a baseline standardized uptake value (SUV) <3.5 and/or SUV decline ≥60% had significantly better OS and PFS than those having none, even after adjustment for all potential confounding variables (all P<.001). Conclusions : FDG-PET can detect radiographically occult DM at staging in one-third of patients and spare them from the potentially toxic therapy. Additionally, FDG-PET parameters including baseline SUV and SUV changes may serve as useful clinical markers for predicting the prognosis in LAPC patients.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301614006798
DOI
10.1016/j.ijrobp.2014.05.030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jong Doo(이종두)
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99305
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